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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

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People with learning disabilities still face inequalities in access to health services. This article, which comes with a handout for a journal club discussion, sums up what nurses can do to reduce these inequalities

Launching his annual report, Dr Tony Jewell said the NHS must become more efficient and cut out waste to cope with increasing financial pressure.

But he made clear that individuals also had a responsibility to look after themselves as the NHS was forced to pick up the cost of drinking, smoking and obesity.

Dr Jewell called for smoking to be banned in cars carrying children to protect them from second-hand smoke; he highlighted an estimated 2,500 excess winter deaths in 2008/09, up 74% on the previous year, and he backed calls for the Welsh Assembly to have the power to introduce minimum prices for alcohol to tackle a binge-drinking culture.

Dr Jewell said: “Individuals must also do more for themselves.

“We can only tell people so much of the harms of smoking and drinking and the importance of eating a healthy diet and doing regular exercise.

“But more and more people require treatment for conditions related to obesity, smoking and alcohol abuse - preventable conditions that are draining the resources of the NHS.”

His plea for a more efficient service follows comments this week from First Minister Carwyn Jones that a guarantee to ring-fence all health spending would be “irresponsible”.

Although the administration will protect hospitals from cutbacks emanating from Westminster, Mr Jones said the same promise could not be extended to the rest of the NHS.

Ministers have predicted that spending cuts could force the NHS to find savings of almost £2 billion over the next five years.

Opposition AMs have made repeated attacks on spending since NHS finance directors last year told a cross-party committee that around a fifth of the health budget - some £1 billion - was not spent properly.

Dr Jewell said: “The NHS has, and always will be, a priority for the Assembly government - demonstrated by 40% of our budget being invested in health and social services.

“However, we must continue to work to become more efficient and effective in the way we deliver services in order to improve patient safety, sustainability and clinical quality.”

Unnecessary procedures and hospital infections must end, he said.

“Treatments need to be evidence-based, rather than undertaken simply because they have become accepted practice over time,” he added.

“Waste must be cut out. It is estimated that up to 50% of prescribed medicines are not taken as intended or at all by patients, and in September we launched a campaign to encourage people to reduce the amount of medicines they do not use or throw out.”

Clinicians must do their best to adopt best practice or justify why they have not, and patients need help to understand the reasons behind their treatment, he said.

I don’t say this in a judgemental way but cats are pointless. During the war, when people were training dogs to sniff out bombs and dolphins to use the telephone, they tried to get cats to help but cats couldn’t be bothered.

Efforts to boost health professionals’ knowledge of nutrition and ensure they feel confident talking to patients about sensitive topics like weight are among steps designed to tackle the UK’s obesity crisis set out in the long-term plan for the NHS in England.

Readers' comments (2)

Fine, well done, very laudable, good idea and all that! But how is this to be achieved? Even in the USA where there is a real financial incentive to look after yourself and keep well, they have similar public health problems.

i am slowly losing patience with all those one observes around who look old, decrepid and wrinkled but nevertheless continue to chain smoke and drink all day long (or take drugs), or stuff themselves excessively and with the unhealthy foodstuffs, and any other damaging practices. i have studiied all the psychopathologies etc. of all these problems and the often devastating personal reasons which has led them some of them to this appaling state and what support available for them. but is there really any excuse? many have tough lives which don't always turn out as expected and are able to take other measures to remain fit and healthy despite financial and social hardships. i can appreciate if circumstances which lead people into such crises but smoking and alcohol and sitting around also costs money too and maybe just as much or more than taking some form of exercise, and walking is even free. what is really the answer? it is so sad to see my neighbour today out in the street, elderly, bent double with his pipe constantly hanging out of his mouth and even outdoors. maybe his condition leads him to smoke but equally it must have exacerbated it as well as he can hardly breath. but there really must be other solutions. another shocking example is a lady i saw with a baby attached to her chest in a sling with all her cigarette smoke blowing into its face, and this is not the first time i have witnessed such a scene. i pay the taxes (which go towards paying for everybody's health care, i work on the medical ward, etc. i used to be really shocked to the point of disbelief at comments which said such patients should not be treated and their condition is their own fault, ... genetic, familial, family or social history, mental health dysfunctions, severe depression, etc. ??? etc, etc. but is this really so? besides aren't there other measures to 'self-treat and self-care' before they for these disorders before they fall into our hands which are more self-satisfying, less adictive and less damaging? surely its just as easy to go out for a walk or a coffee, or i don't know what than reach for comfort food, cigarette, bottle of alcohol, pills, drugs, and even unhealthy sex, etc............Nurses and doctors and even some some sportsmen aren't exempt from these negative behavioural patterns of smoking and drinking either.

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